ABSTRACT
Background: For a medication dispensing service to function with quality, continuous evaluation is required, which is why it is necessary to have reliable measurement tools that make it possible. Quality indicators can serve as tools for managing quality, as they are variables that directly or indirectly measure changes in a situation and help evaluate the progress made in addressing it. This article aims to determine the feasibility and reliability of a quality indicator system for a drug dispensing service for paediatric outpatients in two Mexican hospitals. Methods: A study of the development type of health systems and services at a microlevel was conducted from October 2020 to October 2021 in the pharmaceutical service of two Mexican hospitals. To determine the feasibility of the quality indicators, a retrospective evaluation was performed, which considered the indicators that could be calculated with the available information to be feasible. To determine reliability, an inter-observer agreement study (Kappa (κ)) was performed. Results: The feasibility analysis revealed that all five reference indicators related to the structure were feasible in both hospitals. In the Infantil of the Californias hospital, all six process indicators evaluated were feasible, whilst only one was found feasible in H+ Querétaro. As for outcome indicators, only one was feasible in the Infantil of the Californias hospital. The causes of non-feasibility in both hospitals were the non-documentation of the primary data related to the stages of the process and the lack of instruments to measure patient satisfaction. The reliability of the indicators showed little variability. Conclusion: Although not all indicators were feasible, solutions were proposed so that the 15 reference indicators could be used if an organization decided to do so. The reliability of the indicators was demonstrated, evidencing the importance of the data sheet as a tool to generate valid reliable measures.This article is part of the Hospital pharmacy, rational use of medicines and patient safety in Latin America Special Issue: https://www.drugsincontext.com/special_issues/hospital-pharmacy-rational-use-of-medicines-and-patient-safety-in-latin-america/.
ABSTRACT
Introducción: en México, la cuantificación de fármacos en plasma se utiliza para comprobar la toxicidad, el cumplimiento y la titulación de dosis en el tratamiento con fármacos anticonvulsivos como el ácido valproico (AVP), pero sin considerar los principios de farmacocinética debido a la ausencia de farmacéuticos clínicos en el Sistema de Salud. Método: el presente estudio es un análisis retrospectivo que incluye los datos de concentración plasmática de ácido valproico en pacientes pediátricos de 1 a 15 años de edad, con diagnóstico confiable de epilepsia. Resultados: se revisaron los archivos de 260 pacientes, se encontró que solo el 56,5% de los pacientes tenían niveles séricos en estado estacionario. Los niveles plasmáticos de AVP se encontraron a nivel subterapéutico en el 22% de los pacientes y el 15% tenían niveles tóxicos. El análisis muestra que los niños menores de cinco años aparecen como un grupo heterogéneo para las variables estudiadas. Conclusiones: debido a la falta de reconocimiento de los farmacéuticos clínicos en México, recomendamos que el mejor resultado clínico se evalúe mediante el monitoreo de los parámetros farmacocinéticos y no solo mediante la dosificación de prueba y error. (AU)
Introduction: in Mexico, plasma drug quantitation is used to check toxicity, compliance, and dose titration in treatment with antiepileptic drugs like valproic acid (AVP), but without considering the principles of pharmacokinetics due to the absence of clinical pharmacists into the Health System. Method: the present study is a retrospective analysis including the plasmatic concentration data of AVP in pediatric patients of 1 to 15 years old, who had received a reliable diagnosis of epilepsy. Results: files of 260 patients were reviewed. It was found that only 56,5% of the patients had serum levels at steady state. The plasma AVP levels were found in sub-therapeutic level in 22% of patients and 15% had toxic levels. The analysis shows that children under five years of age appear as a heterogeneous group for the variables studied. Conclusions: due to the lack of recognition of clinical pharmacists in Mexico, we recommend that best clinical outcome can be evaluated only by monitoring pharmacokinetic parameters for variations appearing in individual patients, and not just through trial and error dosing.
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , 34628 , Valproic Acid , Pediatrics , MexicoABSTRACT
Punica protopunica Balf. is one of only two species housed by the Punica genera. Punica protopunica. Balf., known as Socotran pomegranate, is an endemic, isolated species found only in Socotra archipelago in the northwestern Indian Ocean, and is considered to be the ancestor of pomegranate. This review stems from the fact that in many Punica granatum L. articles, Punica protopunica Balf. is mentioned, but just in an informative way, without mentioning their taxonomic and genetic relationship and their medicinal properties. It is there where the need arises to know more about this forgotten species: "the other pomegranate tree." A large part of the human population does not know of its existence, since only its "sister" has spread throughout the world. The present review deals with the taxonomy and origin of Punica protopunica Balf., the morphology of the tree, distribution, cultivation, vulnerability, and as well as its relationship with Punica granatum L. It also discusses its uses in traditional medicine, its antioxidant capacity, and the medicinal properties of this forgotten species.
